NEW ORLEANS (AAAAI) - Food establishments pose a threat to peanut/tree nut allergic individuals when restaurant staff lack knowledge about food allergy and the danger of cross-contamination in the kitchen, according to a study released yesterday at the AAAAI Annual Meeting. The study was conducted by Scott Sicherer, MD and colleagues from the Jaffe Food Allergy Institute (Mount Sinai School of Medicine) and the Food Allergy and Anaphylaxis Network.

Of the 5,171 registrants in the National Peanut and Tree Nut Allergy Registry, 706 people had at least one allergic reaction associated with dining at a restaurant or other food establishment. Through telephone interviews using a structured questionnaire, researchers obtained details about 156 episodes from 129 randomly selected subjects. Reactions were caused by peanuts in 67% of cases and tree nuts in 24% of cases. Certain establishments were commonly cited by subjects: Asian restaurants (19%), ice cream shops (14%) and bakeries/doughnut shops (13%). In episodes where subjects were actively avoiding the food they were allergic to, 65% of the reactions were caused by foods that staff knew to contain peanut/tree nut as an ingredient. In 50% of these incidents, the food item was "hidden" in sauces, dressings or egg rolls. In 18% of allergic episodes, cross-contamination was caused primarily by shared ice cream equipment and cooking/serving supplies. Only 38% of patients specifically warned the establishment of their allergy.

Researchers concluded that food establishments pose a number of specific dangers for peanut/tree nut allergic individuals, particularly concerning cross-contamination and ingestion of unexpected ingredients in desserts and Asian food. To prevent such episodes, researchers suggest that food allergic individuals clearly communicate their allergy to food establishments and that these establishments train their staff to be aware of the seriousness of food allergy and the manner in which cross-contamination can occur.